Tandem Mentorship Program appreciates your interest in becoming a mentor! After we receive your application we will contact your 3 personal references that you provide below and send you a link to fill out a background check form. After your application is approved we will set up an in-home interview with you.

Thank you again for helping to further His Kingdom through mentoring a youth facing adversity.

Show me the path where I should walk, O Lord, point out the right road for me to follow." Psalm 25:4

* Required

Name (First, M, Last) *

Home Address *

Phone Number (Home and Mobile) *

Email

Preferred Method of Communication *

Email

Phone

Mail

Date of Birth *

MM

/

DD

/

YYYY

Martial Status *

Choose

Married

Single

Divorced

Domestic Partnership

Widowed

Separated

Spouse's Name

Gender *

Female

Male

Ethnicity *

Choose

African American

American Indian/Native American

Caucasian

Asian/Pacific Islander

Hispanic/ Latino

Multi-racial

Other

No Preference

Disability *

Yes

No

Type of Disability

Availability *

Monday AM

Monday PM

Tuesday AM

Tuesday PM

Wednesday AM

Wednesday PM

Thursday AM

Thursday PM

Friday AM

Friday PM

Saturday AM

Saturday PM

Sunday AM

Sunday PM

Required

Do you own your own car? *

Yes

No

If you plan to transport your mentee please upload a picture of your Driver's License. If you're unable to upload, you can e-mail a photo to hello@tandemmentorship.com

Add file

If you plan to transport your mentee please upload a picture of your auto insurance card. If you're unable to upload, you can e-mail a photo to hello@tandemmentorship.com

Add file

Are you willing to be matched with a mentee from a home of...

Emotional Abuse

Sexual Abuse

Physical Abuse

Substance Abuse

Education Level *

Choose

Less than High School

H.S. Diploma or Equivalent (GED)

Associates Degree

Bachelor's Degree

Master's Degree

Professional Degree

Some College

Other

No Degree

Why do you want to become a mentor for a youth facing adversity? *

Please list the names, e-mails, and phone numbers of 3 people you would like to use as personal character references (only people you have known for at least a year). Include at least one person who can comment on your current walk with Jesus. *

Please write down your interests and a few activities you would like to do with a mentee *

How did you hear about Tandem? *

Word of Mouth

Website

Facebook

Newsletter

Other Organization or Church

Required

Check any other volunteer opportunities you'd be interested in.

Sport Group Events

Guitar Lessons

Game Nights

Bible Studies

Recruiting Other Mentors

Office Administration

Fundraising

Event Volunteer

Please list all other cities, states, and dates of residency during the past 10 years. *

Please list the names and ages of your household members. *

Please provide employment information for the past 5 years. Include company name, position held and length/duration of employment. *

How would you describe your relationship with Christ? How would you share your faith-walk with your mentee? *

Do you have any previous experience volunteering or working with youth facing adversity? If so, please specify. *

Have you ever been arrested or convicted of a crime? If so, what were the circumstances? *

Have you ever been convicted of a DUI, driving while under the influence of alcohol? If yes, when and what were the circumstances? *

Have you ever been treated or hospitalized for a mental health disorder? If yes, please explain. *

Have you ever been treated for alcohol or substance abuse? If yes, please explain. *

Have you ever been investigated or convicted of child abuse, neglect, sexual abuse or molestation of a youth 18 or younger? If yes, please explain. *